Healthcare Provider Details

I. General information

NPI: 1811992829
Provider Name (Legal Business Name): ASHFORD HEALTHCARE SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23186 BLUESTAR HIGHWAY
QUINCY FL
32353-1979
US

IV. Provider business mailing address

PO BOX 1979
QUINCY FL
32353-1979
US

V. Phone/Fax

Practice location:
  • Phone: 850-875-1100
  • Fax: 850-875-1454
Mailing address:
  • Phone: 850-875-1100
  • Fax: 850-875-1454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number282NC0060X
License Number StateFL

VIII. Authorized Official

Name: MS. CYNTHIA CASTEEL
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 850-875-1100